Presentation is loading. Please wait.

Presentation is loading. Please wait.

18 The Integumentary System 1. Define important words in this chapter bony prominences areas of the body where the bone lies close to the skin. bruise.

Similar presentations


Presentation on theme: "18 The Integumentary System 1. Define important words in this chapter bony prominences areas of the body where the bone lies close to the skin. bruise."— Presentation transcript:

1 18 The Integumentary System 1. Define important words in this chapter bony prominences areas of the body where the bone lies close to the skin. bruise a purple, black, or blue discoloration on the skin caused by the leakage of blood from broken blood vessels into the surrounding tissues; also called a contusion. closed wound a type of wound in which the skin’s surface is not broken. dermis the inner layer of the two main layers of tissue that make up the skin.

2 18 The Integumentary System 1. Define important words in this chapter eczema a temporary or chronic skin disorder that results in redness, itching, burning, swelling, cracking, weeping, and lesions; also called dermatitis. epidermis the outer layer of the two main layers of tissue that make up the skin. gangrene death of tissue caused by infection or lack of blood flow. integument natural protective covering.

3 18 The Integumentary System 1. Define important words in this chapter lesion an area of abnormal tissue or an injury or wound. melanin the pigment that gives skin its color. melanocyte cell in the skin that produces and contains the pigment called melanin. necrosis the death of living cells or tissues caused by disease or injury.

4 18 The Integumentary System 1. Define important words in this chapter open wound a type of wound in which the skin’s surface is not intact. pressure points areas of the body that bear much of its weight. pressure ulcer a serious wound resulting from skin breakdown; also known as pressure sore, decubitus ulcer, or bed sore. psoriasis a chronic skin condition caused by skin cells growing too quickly which results in red, white, or silver patches, itching and discomfort.

5 18 The Integumentary System 1. Define important words in this chapter scabies a contagious skin infection caused by mites burrowing into the skin that results in pimple-like irritations, rashes, intense itching, and sores. shingles a viral infection caused by the same virus that causes chickenpox; results in pain, itching, rashes, and possibly fever and chills. sitz bath a warm soak of the perineal area to clean perineal wounds and reduce inflammation and pain.

6 18 The Integumentary System 1. Define important words in this chapter skin cancer the growth of abnormal skin cells; symptoms include changes in mole, wart, or spot on the skin, sores that do not heal, itching, pain, and skin that is oozing or bleeding. tinea a fungal infection that causes red, scaly patches to appear in a ring shape, generally on the upper body, or the hands and feet. wart contagious hard bump caused by a virus.

7 18 The Integumentary System 2. Explain the structure and function of the integumentary system Define the following terms: integument natural protective covering. epidermis the outer layer of the two main layers of tissue that make up the skin. melanocyte cell in the skin that produces and contains the pigment called melanin. melanin the pigment that gives skin its color.

8 18 The Integumentary System 2. Explain the structure and function of the integumentary system Define the following term: dermis the inner layer of the two main layers of tissue that make up the skin.

9 18 The Integumentary System 2. Explain the structure and function of the integumentary system The integumentary system consists of the following parts: the skin, hair, nails, oil glands, sweat glands, subcutaneous tissue, and nerve endings. The skin is a natural protective covering, or integument.

10 18 The Integumentary System Transparency 18-1: The Integumentary System

11 18 The Integumentary System 2. Explain the structure and function of the integumentary system Remember these points about the integumentary system: Natural, protective covering Largest organ and system Covers and protects the body Skin is a sense organ

12 18 The Integumentary System 2. Explain the structure and function of the integumentary system Functions of the integumentary system: Protects internal organs from injury Protects body against bacteria Prevents loss of too much water Regulates body temperature Responds to heat, cold, pain, pressure, and touch Excretes waste products in sweat Helps with production of vitamin D

13 18 The Integumentary System 3. Discuss changes in the integumentary system due to aging Normal changes of aging in the integumentary system: Amount of fat and collagen decreases. Elastic fibers lose elasticity. Hair and nail growth slows. Skin becomes drier. Skin becomes thinner and more fragile. Protective fatty layer thins. Hair thins and turns gray. Brown spots may appear on the skin.

14 18 The Integumentary System 4. Discuss common disorders of the integumentary system Remember these points about burns and scalds: Causes: fire, hot liquids, warm water applications, electrical equipment, hot objects, certain chemicals First-degree, or superficial, burns affect the epidermis and cause redness and pain. Second-degree, or partial-thickness, burns affect the dermis and cause some skin damage, redness, pain, swelling and blistering. Third-degree, or full-thickness, burns affect the epidermis, dermis and underlying tissue and cause serious scarring, which may affect muscle and bone; white or charred skin; pain, swelling, and peeling skin. Very painful

15 18 The Integumentary System 4. Discuss common disorders of the integumentary system Points about burns and scalds (cont’d.): May require surgery Can cause resident’s condition to deteriorate rapidly Offer pain medication before beginning care. Be gentle with moving and positioning. Report pus or other fluids around burn area or complaints of pain.

16 18 The Integumentary System 4. Discuss common disorders of the integumentary system Define the following term: scabies a contagious skin infection caused by mites burrowing into the skin that results in pimple-like irritations, rashes, intense itching, and sores.

17 18 The Integumentary System 4. Discuss common disorders of the integumentary system Remember these points about scabies: Cause: mites that burrow into the skin to lay eggs Symptoms: rash, intense itching, sores that may become infected Usually transmitted by person-to-person contact Elderly and those with weak immune systems at higher risk Treatment: special lotions

18 18 The Integumentary System 4. Discuss common disorders of the integumentary system Define the following term: shingles a viral infection caused by the same virus that causes chickenpox; results in pain, itching, rashes, and possibly fever and chills.

19 18 The Integumentary System 4. Discuss common disorders of the integumentary system Remember these points about shingles: Cause: viral infection (varicella-zoster virus, same virus that causes chickenpox) Can occur in anyone who has had chickenpox Symptoms: begins with pain or itching where rash will appear; fever, chills Pain may last for many years. Virus is spread when in blister form. Keep rash covered at all times. Treatment: medication

20 18 The Integumentary System 4. Discuss common disorders of the integumentary system Define the following terms: open wound a type of wound in which the skin’s surface is not intact. closed wound a type of wound in which the skin’s surface is not broken. bruise a purple, black, or blue discoloration on the skin caused by the leakage of blood from broken blood vessels into the surrounding tissues; also called a contusion.

21 18 The Integumentary System 4. Discuss common disorders of the integumentary system Remember these points about wounds: Types of open wounds: abrasion, avulsion, incision, laceration, puncture wound A common type of closed wound is a contusion, or bruise. Symptoms: pain, tissue damage, discoloration, bleeding, fever, chills, trouble breathing New wounds require immediate attention. Treatment: stopping bleeding, cleaning wound, applying dressing

22 18 The Integumentary System 4. Discuss common disorders of the integumentary system Define the following term: lesion an area of abnormal tissue or an injury or wound.

23 18 The Integumentary System 4. Discuss common disorders of the integumentary system Know these types of skin lesions: Papules are skin lesions that are raised, little round bumps on the skin. They do not contain pus. Contact dermatitis is an example. Pustules are raised spots filled with pus, such as acne or infected boils. Vesicles are small blisters that contain fluid. They can occur on the skin or inside the mouth. Chickenpox is an example. Wheals are large raised, irregular areas, that are usually itchy. Hives from an allergic reaction are an example.

24 18 The Integumentary System 4. Discuss common disorders of the integumentary system Types of skin lesions (cont’d.): Hematoma is a collection of blood in one area. The spot can be visible as a bruise, but may also occur on internal organs. Hematomas can become larger over time. They may also change color. Purpura are small, purplish spots caused by bleeding under the skin. In elderly people, these spots are called senile purpura. Senile purpura occurs because blood vessels become more fragile with age.

25 18 The Integumentary System 4. Discuss common disorders of the integumentary system Define the following term: gangrene death of tissue caused by infection or lack of blood flow.

26 18 The Integumentary System 4. Discuss common disorders of the integumentary system Remember these points about gangrene: Means death of tissue Caused by lack of blood flow Must be treated immediately Causes: burns, diabetes, injuries, circulatory disorders, weakened immune system, complications from surgery Symptoms: discoloration of skin, sores that do not heal, pain, loss of feeling, foul-smelling discharge, chills, change in vital signs Report elevated temperature, pulse, or respiration rate; changes in blood pressure or difficulty breathing. Treatment: antibiotics, surgery, amputation, hospitalization

27 18 The Integumentary System 4. Discuss common disorders of the integumentary system Define the following term: eczema a temporary or chronic skin disorder that results in redness, itching, burning, swelling, cracking, weeping, and lesions; also called dermatitis.

28 18 The Integumentary System 4. Discuss common disorders of the integumentary system Remember these points about eczema: General term for a variety of skin problems Causes: stress, allergies, family history, irritating agents in environment Treatment: topical steroid creams, soothing or drying lotions Report: worsening of eczema, severe itching or pain, signs of infection

29 18 The Integumentary System 4. Discuss common disorders of the integumentary system Define the following term: psoriasis a chronic skin condition caused by skin cells growing too quickly which results in red, white, or silver patches, itching and discomfort.

30 18 The Integumentary System 4. Discuss common disorders of the integumentary system Remember these points about psoriasis: Chronic skin condition in which skin cells grow too fast Symptoms: white or silver patches on skin, itching and discomfort, arthritis, pain Causes: usually inherited; may be caused by dry climate, cold weather, stress, or weakened immune system Treatment: topical creams, shampoos, and lotions; medication, phototherapy, dietary changes, sun therapy

31 18 The Integumentary System 4. Discuss common disorders of the integumentary system Define the following term: tinea a fungal infection that causes red, scaly patches to appear in a ring shape, generally on the upper body, or the hands and feet.

32 18 The Integumentary System 4. Discuss common disorders of the integumentary system Remember these points about fungal infections/tinea: Commonly occur in moist areas of the body Symptoms: red scaly patches, itching, rawness, pain Examples: jock itch, vaginal yeast infections, athlete’s foot, tinea Causes: perspiration, tight-fitting clothing Treatment: topical antifungal creams, medications Report: skin changes, skin abrasions, flaking, redness, sores, scratching

33 18 The Integumentary System 4. Discuss common disorders of the integumentary system Define the following term: wart contagious hard bump caused by a virus.

34 18 The Integumentary System 4. Discuss common disorders of the integumentary system Remember these points about warts: Rough, hard bump on the skin Cause: contagious virus enters skin through cut or tear Treatment: medication, removal with laser or special instrument

35 18 The Integumentary System 5. Discuss pressure ulcers and identify guidelines for preventing pressure ulcers Define the following terms: pressure points areas of the body that bear much of its weight. bony prominences areas of the body where the bone lies close to the skin. necrosis the death of living cells or tissues caused by disease or injury. pressure ulcer a serious wound resulting from skin breakdown; also known as pressure sore, decubitus ulcer, or bed sore.

36 18 The Integumentary System 5. Discuss pressure ulcers and identify guidelines for preventing pressure ulcers When a person is confined to bed for long periods of time, the amount of blood that circulates to the skin is reduced. The risk of skin breakdown increases. This breakdown usually occurs at the points of the body that bear much of the body’s weight. These points are called pressure points, and there are many on the human body. They are mainly located at bony prominences, which are areas of the body where the bone lies close to the skin.

37 18 The Integumentary System Transparency 18-2: Pressure Ulcer Danger Zones

38 18 The Integumentary System 5. Discuss pressure ulcers and identify guidelines for preventing pressure ulcers Bony prominences include the elbows, shoulder blades, sacrum (tailbone), hips and knees (inner and outer parts), ankles, heels, toes, and the back of the neck and the head. Other areas at risk for skin breakdown include the ears, the area under the breasts or scrotum, the area between the folds of the buttocks or abdomen, and skin between the legs.

39 18 The Integumentary System 5. Discuss pressure ulcers and identify guidelines for preventing pressure ulcers There are four stages of pressure ulcers: Stage 1 Skin is intact, but reddens or appears blue or gray May appear purple or darker than the skin surrounding the area in dark complexions Skin may be swollen or feel warm or firm Redness or discoloration is not relieved within 15 to 30 minutes after removing pressure Can be reversed if discovered promptly and treated If not treated promptly, the pressure ulcer will worsen and progress into other stages

40 18 The Integumentary System 5. Discuss pressure ulcers and identify guidelines for preventing pressure ulcers Four stages of pressure ulcers (cont’d.): Stage 2 Partial-thickness skin loss involving the epidermis and the dermis Ulcer is superficial and looks like a blister or shallow crater Accompanied by pain Skin around the pressure ulcer may be discolored No dead (necrotic) tissue in the site at this stage.

41 18 The Integumentary System 5. Discuss pressure ulcers and identify guidelines for preventing pressure ulcers Four stages of pressure ulcers (cont’d.): Stage 3 Full thickness skin loss (both the epidermis and dermis will be gone) Ulcer looks like a deep crater Bottom of the wound may have yellow, dead tissue Damage may extend to the muscle Require weeks or months to fully heal

42 18 The Integumentary System 5. Discuss pressure ulcers and identify guidelines for preventing pressure ulcers Four stages of pressure ulcers (cont’d.): Stage 4 Full thickness skin loss extending through all layers of the skin, tissue, and possibly, muscle, bone, and other structures, such as joints or tendons Ulcer will look like a deep crater and will have some necrotic tissue Healing process extends over months Serious infections can result May require a skin graft

43 18 The Integumentary System 5. Discuss pressure ulcers and identify guidelines for preventing pressure ulcers Think about this question: Why should every resident’s skin be inspected each time that care is provided?

44 18 The Integumentary System Transparency 18-3: Observing the Skin Observe the skin carefully for signs of skin breakdown, including the following: Pale, white, reddened, gray, or purple skin Dry, cracked, or flaking skin Torn skin Blisters, bruises, or wounds on the skin Rashes or any discoloration Tingling, warmth, or burning of skin Itching or scratching Swelling of skin Wet skin Broken skin anywhere on the body Changes in existing wounds or ulcers

45 18 The Integumentary System 5. Discuss pressure ulcers and identify guidelines for preventing pressure ulcers Risk factors for pressure ulcers include the following: Immobility Wrinkled linens that do not lie flat Crumbs or other irritating objects in bed Malnutrition or dehydration Urinary incontinence

46 18 The Integumentary System 5. Discuss pressure ulcers and identify guidelines for preventing pressure ulcers Remember these guidelines for prevention of pressure ulcers: Report changes in skin. Perform regular skin care and closely observe skin. Keep skin clean and dry. Assist immobile residents to change position often, at least every two hours. Ask residents in wheelchairs to change position often. Avoid rubbing skin against surfaces during transfers.

47 18 The Integumentary System 5. Discuss pressure ulcers and identify guidelines for preventing pressure ulcers Guidelines for prevention of pressure ulcers (cont’d.): Keep linens dry, clean, and wrinkle-free. Perform ROM exercises, as ordered. Massage skin often, if allowed. Use special positioning devices. Use pillows to separate skin surfaces. Follow diet and fluid orders. Use moisturizers, as ordered, on unbroken skin.

48 18 The Integumentary System 6. Explain the benefits of warm and cold applications Know these points about warm and cold applications: Heat relieves pain and muscular tension, decreases swelling, elevates temperature in the tissues, increases waste removal, and brings more oxygen and nutrients to tissues for healing. Cold helps stop bleeding, prevents swelling, reduces pain and brings down high temperatures. Moisture strengthens the effect of heat and cold. Observe for excessive redness, pain, blisters, or numbness

49 Applying warm moist compresses Equipment: washcloth or compress, plastic wrap, towel, basin, bath thermometer 1.Identify yourself by name. Identify the resident. Greet the resident by name. 2.Wash your hands. 3.Explain procedure to resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. 4.Provide for the resident’s privacy with a curtain, screen, or door.

50 Applying warm moist compresses 5.Fill basin one-half to two- thirds with warm water. Test water temperature with thermometer or your wrist. Ensure it is safe. Water temperature should be no more than 105°F. Have resident check water temperature. Adjust if necessary. 6.Soak the washcloth in the water. Wring it out. Immediately apply it to the area needing a warm compress. Note the time. Quickly cover the washcloth with plastic wrap and the towel to keep it warm.

51 Applying warm moist compresses 7.Check the area every five minutes. Remove the compress if the area is red or numb or if the resident has pain or discomfort. Change the compress if cooling occurs. Remove the compress after 20 minutes. 8.Commercial warm compresses are also available. If you are using these, follow the package directions and the nurse’s instructions. 9.Remove privacy measures. Make resident comfortable.

52 Applying warm moist compresses 10.Empty, rinse, and wipe basin. Return to proper storage. Discard plastic wrap. 11.Place soiled clothing and linens in appropriate containers. 12.Leave call light within resident’s reach. 13.Wash your hands. 14.Be courteous and respectful at all times. 15.Report any changes in the resident to the nurse. Document procedure using facility guidelines.

53 Administering warm soaks Equipment: towel, basin, bath thermometer, bath blanket 1.Identify yourself by name. Identify the resident. Greet the resident by name. 2.Wash your hands. 3.Explain procedure to resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. 4.Provide for the resident’s privacy with a curtain, screen, or door.

54 Administering warm soaks 5.Fill the basin half full of warm water. Test water temperature with thermometer or your wrist, and ensure it is safe. Water temperature should be no more than 105°F. Have resident check water temperature. Adjust if necessary. 6.Immerse the body part in the basin. Pad the edge of the basin with a towel if needed. Use a bath blanket to cover the resident if needed for extra warmth.

55 Administering warm soaks 7.Check water temperature every five minutes. Add warm water as needed to maintain the temperature. Never add water warmer than 105°F. To prevent burns, tell the resident not to add warm water. Observe the area for redness. Discontinue the soak if the resident has pain or discomfort. 8.Soak for minutes, or as ordered. 9.Remove basin. Use the towel to dry the resident. 10.Remove privacy measures. Make resident comfortable.

56 Administering warm soaks 11.Empty, rinse, and wipe basin. Return to proper storage. 12.Place soiled clothing and linens in appropriate containers. 13.Leave call light within resident’s reach. 14.Wash your hands. 15.Be courteous and respectful at all times. 16.Report any changes in the resident to the nurse. Document procedure using facility guidelines.

57 Applying an Aquamatic K-Pad® Equipment: K-Pad® and control unit, covering for pad, distilled water 1.Identify yourself by name. Identify the resident. Greet the resident by name. 2.Wash your hands. 3.Explain procedure to resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. 4.Provide for the resident’s privacy with a curtain, screen, or door.

58 Applying an Aquamatic K-Pad® 5.Make sure the surface on the bedside table is dry. Place the control unit on the bedside table. Make sure cords are not frayed or damaged. Check that tubing between pad and unit is intact. 6.Remove cover of control unit to check level of water. If it is low, fill it with distilled water to the fill line. 7.Put the cover of control unit back in place.

59 Applying an Aquamatic K-Pad® 8.Plug unit in. Turn unit on. Temperature should have been pre-set. If it was not, check with the nurse for proper temperature. If you need to set the temperature, you must remove the key after doing so. Place key in proper place. 9.Place the pad in the cover. Do not pin the pad to the cover. 10.Uncover area to be treated. Place the covered pad. Note the time. Make sure the tubing is not hanging below the bed. It should be coiled on the bed. Make sure tubing has no kinks.

60 Applying an Aquamatic K-Pad® 11.Return and check area every five minutes. Remove the pad if the area is red or numb or if the resident reports pain or discomfort. 12.Check water level. Refill with distilled water to the fill line when necessary. 13.Turn off unit and remove pad after 20 minutes. 14.Remove privacy measures. Make resident comfortable. 15.Clean K-pad® according to instructions and return to storage.

61 Applying an Aquamatic K-Pad® 16.Place used linen in appropriate container. 17.Leave call light within resident’s reach. 18.Wash your hands. 19.Be courteous and respectful at all times. 20.Report any changes in the resident to the nurse. Document procedure using facility guidelines.

62 18 The Integumentary System 6. Explain the benefits of warm and cold applications REMEMBER: These procedures should only be performed if allowed by your facility and if you are trained to perform the procedure.

63 18 The Integumentary System 6. Explain the benefits of warm and cold applications Define the following term: sitz bath a warm soak of the perineal area to clean perineal wounds and reduce inflammation and pain.

64 18 The Integumentary System 6. Explain the benefits of warm and cold applications Remember these guidelines about sitz baths: Sitz baths cause circulation to be increased to the pelvic area, which means blood flow to other parts of the body decreases. Residents may feel weak, faint, or dizzy after a sitz bath. Stop the bath if the resident complains of feeling dizzy or faint. Sitz baths may cause the urge to void. Always wear gloves when helping with a sitz bath.

65 Assisting with a sitz bath Equipment: disposable sitz bath, bath thermometer, towels, gloves 1.Identify yourself by name. Identify the resident. Greet the resident by name. 2.Wash your hands. 3.Explain procedure to resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. 4.Provide for the resident’s privacy with a curtain, screen, or door. 5.Put on gloves.

66 Assisting with a sitz bath 6.Fill the sitz bath container two-thirds full with warm water. Place the sitz bath on the toilet seat. Water temperature should generally be no more than 105°F. Check the water temperature using the bath thermometer. If the sitz bath is ordered for pain and to stimulate circulation, the water temperature may need to be higher. Follow the care plan.

67 Assisting with a sitz bath 7.Help the resident undress and get seated on the sitz bath. A valve on the tubing connected to the bag allows the resident or you to fill the sitz bath again with warm water. 8.You may be required to stay with the resident during the bath for safety reasons. If you leave the room, check on the resident every five minutes to make sure he or she is not dizzy or weak. Make sure resident knows how to use the emergency pull cord in the bathroom if it is needed.

68 Assisting with a sitz bath 9.Help the resident off of the sitz bath after 20 minutes. Provide towels. Help with dressing if needed. 10.Empty, rinse, and wipe sitz bath container. Return to proper storage. 11.Place soiled clothing and linens in appropriate containers. 12.Remove and discard gloves. Wash your hands. 13.Make resident comfortable. Remove privacy measures.

69 Assisting with a sitz bath 14.Leave call light within resident’s reach. 15.Wash your hands. 16.Be courteous and respectful at all times. 17.Report any changes in the resident to the nurse. Document procedure using facility guidelines.

70 Applying ice packs Equipment: ice pack or sealable plastic bag and crushed ice, towels or cover for pack or bag 1.Identify yourself by name. Identify the resident. Greet the resident by name. 2.Wash your hands. 3.Explain procedure to resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. 4.Provide for the resident’s privacy with a curtain, screen, or door.

71 Applying ice packs 5.Fill plastic bag or ice pack one-half to two- thirds full with crushed ice. Seal bag. Remove excess air. Cover bag or ice pack with towel or cover. 6.Apply pack or bag to the area as ordered. Note the time. Use another towel to cover bag if it is too cold. 7.Check the area after five minutes for blisters or pale, white, or gray skin. Stop treatment if resident reports numbness or pain.

72 Applying ice packs 8.Remove ice pack or bag after 20 minutes or as ordered. 9.Remove privacy measures. Make resident comfortable. 10.Empty and store ice pack. 11.Place used linen in appropriate container. 12.Leave call light within resident’s reach. 13.Wash your hands.

73 Applying ice packs 14.Be courteous and respectful at all times. 15.Report any changes in the resident to the nurse. Document procedure using facility guidelines.

74 18 The Integumentary System 7. Discuss non-sterile and sterile dressings Remember these points about sterile and non-sterile dressings: Open wounds increase risk of infection. Non-sterile dressings are applied to wounds that have less chance of infection. Sterile dressings are required when the wound is new, open or draining, or when there is a higher risk of infection.

75 Assisting the nurse with changing a non-sterile dressing Equipment: package of square gauze dressings, adhesive tape, scissors, 2 pairs of gloves, plastic bag 1.Identify yourself by name. Identify the resident. Greet the resident by name. 2.Wash your hands. 3.Explain procedure to resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. 4.Provide for the resident’s privacy with a curtain, screen, or door.

76 Assisting the nurse with changing a non-sterile dressing 5.The nurse will prepare a clean, flat, dry surface for the dressing materials. Keep the plastic bag close by for immediate disposal of old dressing materials. 6.You may be asked to open packages for the nurse or cut strips of tape. Cut pieces of tape long enough to secure the dressing. Open gauze square packages without touching the insides or the gauze. If asked to set package down, place the opened package on a clean, flat surface. 7.Put on gloves.

77 Assisting the nurse with changing a non-sterile dressing 8.Only expose the area where the dressing will be changed. The nurse will remove soiled dressing. Dispose of used dressing in proper container. 9.Remove and discard gloves in plastic bag. 10.Wash your hands. 11.Put on new gloves. The nurse will observe the wound and then apply the fresh gauze over the wound and tape it in place. Assist as directed.

78 Assisting the nurse with changing a non-sterile dressing 12.Remove and discard gloves. Wash your hands. 13.Make resident comfortable. Remove privacy measures. 14.Leave call light within resident’s reach. 15.Wash your hands. 16.Be courteous and respectful at all times. 17.Report any changes in the resident to the nurse. Document procedure using facility guidelines.

79 18 The Integumentary System 7. Discuss non-sterile and sterile dressings Remember these points about sterile dressing care: Sterile field is created. Supplies that are considered sterile: sterile dressings, sterile drapes or pads, tubing and catheters. If any part of the sterile field becomes contaminated, the entire process must be restarted.

80 Applying sterile gloves Equipment: 2 pairs of sterile gloves in correct size 1.Wash your hands. 2.Using a clean, flat, dry surface, remove outer wrapper from gloves. Place inner wrapper on the clean surface. The word “Left” should be on your left side, and the word “Right” should be on your right side. 3.Slowly open the inner wrapper, only touching the small flaps of the wrapper.

81 Applying sterile gloves 4.The gloves will have been placed palm-side up with cuffs in place. Pick up the first glove by the bottom end of the cuff. Slip your fingers into the glove without touching the outside of the glove. If you touch the outside of the glove, it will be contaminated. You will have to start over with a new pair of gloves. Wait to adjust the glove until the second glove is on your other hand.

82 Applying sterile gloves 5.Slip your gloved hand into the second glove in the area under the cuff. 6.Slowly slip the fingers of your ungloved hand into the second glove, and pull it completely over your hand and wrist. 7.With your gloved second hand, finish pulling the first glove up and over the wrist. Adjust the fingers now if any adjustment is necessary.

83 Applying sterile gloves 8.If either glove has a tear in it, stop and start again with the second set of sterile gloves. 9.Keep your gloved hands in front of you and above the level of your waist at all times during the procedure. 10.Assist the nurse with sterile procedure.

84 18 The Integumentary System 7. Discuss non-sterile and sterile dressings Think about this question: Why must the entire process be restarted if any part of the sterile field becomes contaminated?

85 18 The Integumentary System Exam Multiple Choice. Choose the correct answer. 1. The ______ is the outer layer of the skin which is composed of dead cells. (A) Integument (B) Epidermis (C) Dermis (D) Melanocyte 2. The largest organ in the human body is the: (A) Heart (B) Lungs (C) Skin (D) Kidneys

86 18 The Integumentary System Exam (cont’d.) 3. Which of the following is a function of the integumentary system? (A) Regulates hormone levels in the body (B) Prevents the loss of too much water (C) Allows the body to move (D) Provides an environment for the development of a fetus 4. Which of the following is a normal age-related change for the integumentary system? (A) Amount of fat and collagen increases (B) Pressure ulcers occur (C) Hair thickens (D) Skin becomes thinner and more fragile

87 18 The Integumentary System Exam (cont’d.) 5. A burn that affects the epidermis and causes redness and pain is a: (A) First-degree (superficial) burn (B) Second-degree (partial-thickness) burn (C) Third-degree (full-thickness) burn (D) Scald 6. Which of the following is true of scabies? (A) It is caused by a build-up of bacteria in the skin. (B) Symptoms include rash, intense itching, and sores that may become infected. (C) It is not contagious. (D) Teenage children and young adults are at a higher risk of acquiring scabies.

88 18 The Integumentary System Exam (cont’d.) 7. Shingles is a viral infection caused by the same virus that causes _______ and can occur in anyone who has had it. (A) Scabies (B) Herpes (C) Chickenpox (D) Eczema 8. Skin that is not intact is considered a(n): (A) Open wound (B) Closed wound (C) Contusion (D) Bruise

89 18 The Integumentary System Exam (cont’d.) 9. One of the nursing assistant’s responsibilities regarding eczema is: (A) Prescribing topical lotions (B) Reporting signs of infection (C) Draining any oozing fluid from the skin (D) Administering medications 10. In which part of the body do fungal infections often occur? (A) The groin (B) The head (C) The arms (D) The cheeks

90 18 The Integumentary System Exam (cont’d.) 11. The first sign of skin breakdown is: (A) Muscle damage (B) Blackened skin with pressure ulcers (C) Shallow crater (D) Pale, white, reddened, or purple skin 12. A pressure ulcer with partial-thickness skin loss that looks like a blister or shallow crater is a stage ______ pressure ulcer. (A) 1 (B) 2 (C) 3 (D) 4

91 18 The Integumentary System Exam (cont’d.) 13. Which of the following is a condition that increases the risk of pressure ulcers? (A) Resident flexibility (B) Cold air (C) Good circulation (D) Restricted mobility 14. Which of the following statements is true of pressure ulcers? (A) When skin begins to break down, it first turns black. (B) Pressure ulcers are difficult to heal but do not hurt much. (C) Pressure ulcers are impossible to prevent. (D) Pressure ulcers can lead to life-threatening infections.

92 18 The Integumentary System Exam (cont’d.) 15. Benefits of applying heat to the body include: (A) Heat helps stop bleeding (B) Heat increases muscular tension (C) Heat decreases blood flow due to constriction of blood vessels (D) Heat increases movement of oxygen and nutrients into the tissues 16. How does moisture affect warm and cold applications? (A) It strengthens their effects. (B) It reduces their effects. (C) It makes applications less likely to cause injury. (D) It allows applications to be applied for a longer time.

93 18 The Integumentary System Exam (cont’d.) 17. Warm or cold applications should generally be applied for: (A) 10 minutes (B) 20 minutes (C) 30 minutes (D) 40 minutes 18. A sitz bath is used to: (A) Relax the resident (B) Encourage slow, deep breathing (C) Measure a resident’s pulse (D) Increase blood flow to pelvic area

94 18 The Integumentary System Exam (cont’d.) 19. Non-sterile dressings are applied to: (A) Open wounds (B) Draining wounds (C) Dry wounds that have less chance of infection (D) New wounds


Download ppt "18 The Integumentary System 1. Define important words in this chapter bony prominences areas of the body where the bone lies close to the skin. bruise."

Similar presentations


Ads by Google